| Outdoor Psychology, Llc | |
|
205 Ocean Avenue Portland ME 04103 | |
| (207) 808-0428 | |
| (207) 773-5512 |
| Full Name | Outdoor Psychology, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 205 Ocean Avenue, Portland, Maine |
| Authorized Official Name and Position | Annmarie Mica Lageroos (OWNER) |
| Authorized Official Contact | 2078080428 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Outdoor Psychology, Llc 31 Gorham Rd P.o. Box 181 Scarborough ME 04070 Ph: (207) 808-0428 | Outdoor Psychology, Llc 205 Ocean Avenue Portland ME 04103 Ph: (207) 808-0428 |
| NPI Number | 1326501701 |
|---|---|
| Provider Enumeration Date | 04/11/2019 |
| Last Update Date | 04/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326501701 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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